President Obama delivered a characteristically first-rate speech on health-care reform to Congress last night: forceful, detailed, appropriately angry and soaring toward the end with his invocation of the late senator Ted Kennedy. Yet though tens of millions saw it on television, his real audience was just a handful of people, all of them arrayed before him in the House chamber.

Which is why Suzy Khimm of the New Republic wins today's "Most Valuable Pundit" award. Getting straight to the heart of the matter, Khimm checked in with perhaps the two most important centrist senators – Olympia Snowe, a Maine Republican, and Ben Nelson, a Nebraska Democrat. And Khimm found that both of them had posted statements on their websites notable for their warmth.

"The moderates and centrists critical to on-going health care negotiations seemed to have found a good deal to their liking in the president's speech tonight," Khimm writes.

Khimm's small-bore approach to analysing Obama's speech made sense. The president said nothing particularly new, though he explained his priorities more clearly than he had previously. The political forces with which he must contend remain unchanged: a large contingent of liberal Democrats, especially in the House of Representatives, who want a progressive plan that includes a public option; a small group of centrists, mainly in the Senate, who could derail reform if the public option isn't dropped; and the vast majority of Republicans, who apparently have chosen to say "no" to whatever is finally brought up for a vote.

Obama has to chart a middle course between the liberals and the centrists while casting conservative Republicans as unregenerate obstructionists. Needless to say, the Republicans' boorish behaviour during the speech, and especially congressman Joe Wilson's outburst ("You lie!"), played right into the president's hands. (As Roger Simon puts it at the Politico: "If Democrats had shouted 'you lie' every time they thought a Republican president had lied to them, Richard Nixon would still be speaking.")

Tom Shales writes in the Washington Post that Obama "looked and sounded calm and rational, though certainly assertive, while moblike voices railed defiantly against him." Alex Koppelman, blogging at Salon, calls the Republicans' demeanour "a gift," saying it adds to the impression "that Republicans have gone around the bend, that they're more interested in attacking Obama than in reaching across the aisle to work on reform."

But if Obama had some success in marginalising Republicans last night (or, rather, if the Republicans succeeded in marginalising themselves), what of the liberal Democrats who are most vocal in calling for a public option – that is, a government-run vehicle that would compete with private insurance companies?

Obama dealt with them in two ways.

First, he invoked a truly progressive idea that isn't even on the table – a single-payer, Canadian-style health system – for the sole purpose of casting himself as an opponent of such radical change.

Liberal blogger Matthew Yglesias called the move "annoying" but "politically necessary," writing that "if you're going to put forward a very moderate plan you've got to remind people that there really are all these liberals out there who want a real liberal plan."

Second, though Obama endorsed the public option in the most emphatic terms we've heard from him, he also made it clear that he wasn't going to let it stand in the way of a deal. It had to be galling to liberals, who have public sentiment on their side. But it is a fact of political life that Olympia Snowe and Ben Nelson could kill health reform all by themselves.

"Obama's goal was not to present some perfect plan but to support the best plan that can get the votes," writes Slate's John Dickerson, adding, "Obama tried to lay out that path both in detail but also in manner: He played the middleman."

Of course, not everyone was buying what Obama was selling last night. At the Weekly Standard, Fred Barnes sneered with contempt, writing, "It was 40 minutes of boilerplate followed by a socko, emotional finish exploiting the death of Senator Teddy Kennedy." At the conservative Powerline blog, John Hinderaker took issue with Obama's statement that "the time for bickering is over," calling it a "gratuitous insult" and writing: "Debating public policy issues is not 'bickering'."

Still, conservatives would appear to find themselves on the wrong side of the issue. With the guns of August – the crazed town meetings, the "death panels" and the like – now behind us, sort of, it's beginning to dawn on the mainstream media that a healthcare bill along the lines that Obama wants is very likely to pass.

Last night was a chance for Obama to reclaim health care. But the Wilson outburst reminds us that we're living in a profoundly broken culture.

"Congress will pass some form of healthcare reform this year, probably something very close to what the President proposed," writes Time's Joe Klein. "But it will not end the public malignancy that has attended this debate and threatens the democratic fabric of our nation."

It's an ugly time, and all of Obama's bipartisan outreach has been for naught. Last night he signaled that the moment has come to fight – not for the healthcare plan of which liberal dreams are made, but one that can pass despite the forces arrayed against him.